A benign esophageal stricture, or peptic stricture,
is a narrowing or tightening of the
esophagus
The esophagus (American English) or oesophagus (British English; both ), non-technically known also as the food pipe or gullet, is an organ in vertebrates through which food passes, aided by peristaltic contractions, from the pharynx to the ...
that causes swallowing difficulties.
Signs and symptoms
Symptoms of esophageal strictures include
heartburn
Heartburn, also known as pyrosis, cardialgia or acid indigestion, is a burning sensation in the central chest or upper central abdomen. Heartburn is usually due to regurgitation of gastric acid (gastric reflux) into the esophagus. It is the ma ...
, bitter or acid taste in the mouth, choking, coughing, shortness of breath, frequent burping or hiccups, pain or trouble swallowing,
throwing up blood, or weight loss.
Causes
It can be caused by or associated with
gastroesophageal reflux disease
Gastroesophageal reflux disease (GERD) or gastro-oesophageal reflux disease (GORD) is one of the upper gastrointestinal chronic diseases where stomach content persistently and regularly flows up into the esophagus, resulting in symptoms and/ ...
,
esophagitis
Esophagitis, also spelled oesophagitis, is a disease characterized by inflammation of the esophagus. The esophagus is a tube composed of a mucosal lining, and longitudinal and circular smooth muscle fibers. It connects the pharynx to the stomach; s ...
, a dysfunctional
lower esophageal sphincter,
disordered motility,
lye
A lye is a metal hydroxide traditionally obtained by leaching wood ashes, or a strong alkali which is highly soluble in water producing caustic basic solutions. "Lye" most commonly refers to sodium hydroxide (NaOH), but historically has bee ...
ingestion, or a
hiatal hernia. Strictures can form after esophageal surgery and other treatments such as laser therapy or
photodynamic therapy
Photodynamic therapy (PDT) is a form of phototherapy involving light and a photosensitizing chemical substance, used in conjunction with molecular oxygen to elicit cell death (phototoxicity).
PDT is popularly used in treating acne. It is used c ...
. While the area heals, a scar forms, causing the tissue to pull and tighten, leading to difficulty in swallowing.
[Ginex, Pamela K., Manjit S. Bains, Jacqueline Hanson, and Bart L. Frazzitta. 100 Questions & Answers About Esophageal Cancer (100 Questions & Answers). New York: Jones and Bartlett, Inc., 2005. Print.]
Diagnosis
It can be diagnosed with an X-ray while the patient swallows barium (called a
barium study of the esophagus), by a
computerized tomography scan, a biopsy, or by an
endoscopy
An endoscopy is a procedure used in medicine to look inside the body. The endoscopy procedure uses an endoscope to examine the interior of a hollow organ or cavity of the body. Unlike many other medical imaging techniques, endoscopes are insert ...
.
Treatment
If it is caused by esophagitis, in turn caused by an underlying infection, it is commonly treated by treating the infection (typically with antibiotics). In order to open the stricture, a surgeon can insert a
bougie – a weighted tube used to dilate the constricted areas in the esophagus.
[ It can sometimes be treated with other medications. For example, an ]H2 antagonist
H2 antagonists, sometimes referred to as H2RAs and also called H2 blockers, are a class of medications that block the action of histamine at the histamine H2 receptors of the parietal cells in the stomach. This decreases the production of stom ...
(e.g. ranitidine
Ranitidine, sold under the brand name Zantac among others, is a medication used to decrease stomach acid production. It is commonly used in treatment of peptic ulcer disease, gastroesophageal reflux disease, and Zollinger–Ellison syndrome. ...
) or a proton-pump inhibitor
Proton-pump inhibitors (PPIs) are a class of medications that cause a profound and prolonged reduction of stomach acid production. They do so by irreversibly inhibiting the stomach's H+/K+ ATPase proton pump.
They are the most potent inhibitors ...
(e.g. omeprazole
Omeprazole, sold under the brand names Prilosec and Losec, among others, is a medication used in the treatment of gastroesophageal reflux disease (GERD), peptic ulcer disease, and Zollinger–Ellison syndrome. It is also used to prevent upper g ...
) can treat underlying acid reflux disease.
Epidemiology
Gastroesophageal reflux disease
Gastroesophageal reflux disease (GERD) or gastro-oesophageal reflux disease (GORD) is one of the upper gastrointestinal chronic diseases where stomach content persistently and regularly flows up into the esophagus, resulting in symptoms and/ ...
(GERD) affects approximately 40% of adults. Strictures occur in 7 to 23% of patients with GERD who are untreated.
See also
* Esophageal cancer
Esophageal cancer is cancer arising from the esophagus—the food pipe that runs between the throat and the stomach. Symptoms often include difficulty in swallowing and weight loss. Other symptoms may include pain when swallowing, a hoarse voic ...
* Esophageal diseases
* Esophageal spasm
Esophageal spasm is a disorder of motility of the esophagus.
There are two types of esophageal spasm:
* Diffuse or distal esophageal spasm (DES), where there is uncoordinated esophageal contractions
* Nutcracker esophagus (NE) also known as hy ...
* ''Helicobacter pylori
''Helicobacter pylori'', previously known as ''Campylobacter pylori'', is a gram-negative, microaerophilic, spiral (helical) bacterium usually found in the stomach. Its helical shape (from which the genus name, helicobacter, derives) is thoug ...
''
References
External links
*
{{Digestive system diseases
Esophagus disorders